PMID- 35662711
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 13
DP  - 2022
TI  - Pharmacist-Urologist Collaborative Management Improves Clinical Outcomes in 
      Patients With Castration-Resistant Prostate Cancer Receiving Enzalutamide.
PG  - 901099
LID - 10.3389/fphar.2022.901099 [doi]
LID - 901099
AB  - Background: Enzalutamide is useful for the treatment of castration-resistant 
      prostate cancer (CRPC). Despite its usefulness, adverse events (AEs) sometimes 
      force patients to discontinue treatment. To maximize patient care, we developed 
      an ambulatory care pharmacy practice that allows collaboration between a 
      pharmacist and urologist to manage patients with CRPC receiving enzalutamide. In 
      this study, we investigated the efficacy of this collaborative management. 
      Methods: A retrospective chart review of 103 patients with CRPC receiving 
      enzalutamide in our hospital between May 2014 and December 2020 was performed. 
      Our collaborative management was implemented in October 2016. Before being 
      examined by urologists, patients visited the oncology pharmacy consultation room 
      for a face-to-face consultation, wherein the oncology pharmacists assessed 
      factors such as adherence to enzalutamide, any AEs and their grades, and provided 
      their suggestions to the urologists. The time to enzalutamide discontinuation and 
      prostate-specific antigen progression were compared between patients who started 
      enzalutamide before (n = 41) and after (n = 62) the implementation of the 
      collaborative management. A multivariate Cox regression analysis was performed to 
      analyze the factors associated with enzalutamide discontinuation. Results: After 
      implementing collaborative management, the pharmacists had 881 patient 
      consultations. Among the 476 suggestions from pharmacists, 345 were accepted by 
      urologists. The most frequent suggestion was supportive care in enzalutamide 
      treatment (224 suggestions). Multivariate analysis showed that collaborative 
      management [hazard ratio (HR) 0.53, 95% confidence interval (CI) 0.31-0.89, p = 
      0.017] and higher prostate-specific antigen (PSA; HR 2.41, 95% CI 1.36-4.28, p = 
      0.003) were significantly associated with enzalutamide discontinuation. The 
      median time to discontinuation (18.9 vs. 7.6 months, p = 0.012), time to 
      discontinuation due to AEs (not reached in both groups, p = 0.001), and time to 
      PSA progression (13.3 vs. 5.8 months, p = 0.002) were all significantly longer in 
      the after group. Conclusions: We implemented a pharmacist-urologist collaborative 
      management program for outpatients with CRPC receiving enzalutamide. The results 
      revealed that collaborative management was useful for prolonging the time to 
      enzalutamide discontinuation.
CI  - Copyright (c) 2022 Hirabatake, Ikesue, Iwama, Irie, Yoshino, Yamasaki, Hashida, 
      Kawakita and Muroi.
FAU - Hirabatake, Masaki
AU  - Hirabatake M
AD  - Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan.
FAU - Ikesue, Hiroaki
AU  - Ikesue H
AD  - Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan.
FAU - Iwama, Yuna
AU  - Iwama Y
AD  - Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan.
FAU - Irie, Kei
AU  - Irie K
AD  - Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Kobe Gakuin 
      University, Kobe, Japan.
FAU - Yoshino, Shintaro
AU  - Yoshino S
AD  - Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan.
FAU - Yamasaki, Toshinari
AU  - Yamasaki T
AD  - Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan.
FAU - Hashida, Tohru
AU  - Hashida T
AD  - Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan.
AD  - Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Kobe Gakuin 
      University, Kobe, Japan.
FAU - Kawakita, Mutsushi
AU  - Kawakita M
AD  - Department of Urology, Kobe City Medical Center General Hospital, Kobe, Japan.
FAU - Muroi, Nobuyuki
AU  - Muroi N
AD  - Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan.
LA  - eng
PT  - Journal Article
DEP - 20220519
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC9162505
OTO - NOTNLM
OT  - Castration-Resistant Prostate Cancer (CRPC)
OT  - ambulatory care
OT  - collaborative management
OT  - enzalutamide (ENZ)
OT  - pharmacist
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/06/07 06:00
MHDA- 2022/06/07 06:01
PMCR- 2022/05/19
CRDT- 2022/06/06 13:47
PHST- 2022/03/21 00:00 [received]
PHST- 2022/04/26 00:00 [accepted]
PHST- 2022/06/06 13:47 [entrez]
PHST- 2022/06/07 06:00 [pubmed]
PHST- 2022/06/07 06:01 [medline]
PHST- 2022/05/19 00:00 [pmc-release]
AID - 901099 [pii]
AID - 10.3389/fphar.2022.901099 [doi]
PST - epublish
SO  - Front Pharmacol. 2022 May 19;13:901099. doi: 10.3389/fphar.2022.901099. 
      eCollection 2022.